A journal of healing

Archive for the ‘therapy’ Category

I was born in America. I have never experienced anything but the freedoms we have here in this country. I do not know any better and so I take it for granted. I am disgusted by piss-poor politicians and can be vocal about my feelings. I am entitled. I take for granted the rights and liberties we have. But I am proud to be an American.

However, I hate the way we celebrate this holiday with fireworks. I personally love the display and the colors. But I hate the noise. It upsets my little Cookie.

Last night we were all sitting in the garden as is our ritual before bed. The dogs take a walk around the yard. We call it the perimeter check. And then we sit for a bit and meditate. There were a few little pops in the distance and Cookie was a bit nervous but still quiet. Then a neighbor set off a huge firework which exploded right over the garden. She panicked.

We ran inside and she took off for the bedroom. I had prepared for this and had the air conditioner and fans going. We crawled into bed and she crawled on top of me and shook. I finally calmed her down and she fell asleep next to me but in my arms. I thought we were ok when another one went off. She again crawled on top of my chest and buried her face in my arms. Finally they stopped and she fell asleep attached to me on my side.

I know everyone has the right to celebrate. I wish they would go back to making fireworks illegal in NY. There are enough displays that are set off by the municipalities to enjoy. I am sure tonight and the next night will be even worse for my little dogs. Browny does not seem to get upset by the noise. But he does get upset when Cookie is upset.

I wish I could teach them something I just learned. I am taking a class to become a Certified Trauma Professional. This class has taught me so much about PTSD and trauma. It is taught by Dr. Eric Gentry, who is an internationally recognized leader in the field of disaster and clinical traumatology.

He teaches that people cannot feel the effects of stress or trauma in a relaxed body. Seems so simple. But he explains in length how the human body is always reacting to triggers of some kind. People who have had extended periods of some form of trauma are in a hypervigilant mode all the time. There are chemical reactions in the brain and the parasympathetic and sympathetic systems go into over drive. In short, our body is in control.

He explains that we need to be aware that this is always on in one degree or another. And we react by constricting our muscles all day. An example is when at the end of the day, you neck and shoulders are way up and hurt and you have no idea why. It is the constriction of the muscles that you held in a clench all day. We clench our muscles everywhere. It is one cause of leg cramps and back pain.

It is common now for people to understand the concept of just take a breath. Dr. Gentry talks about the power of just taking a breath. He talked about other methods for getting control. But the method I think is amazing and it works is called the pelvic floor relaxation. First you have to become aware of the muscles in you hip area. Do a few kegal exercises by squeezing the muscles that can stop you when you pee. Now just completely relax that area completely. Do that several times a day. Concentrate on those muscles being relaxed when something stressful is happening and you will find you won’t be as stressed.

The issue is that the effect only lasts for a very short time. This is something you have to do all the time. It only takes a second and no one knows you are doing it. Another method to use is called the wet noodle. This is where you go absolutely limp in a chair for ten seconds. It is like a mini vacation. The effect of being in a relaxed body is how people are learning to deal with PTSD and every day stress.

I wish I could teach my little pup this. But for her, the only comfort is a dark quiet room and being held by her Mommer.

People who are diagnosed with PTSD will relate to this post. I am of the belief that there really is no cure for it and that it is an easy beast to get captured by and eaten. All the therapy in the world will never truly vanquish the beast. But therapy may help to armor up and fight.

I am ensnared at work in a most ridiculous, piss-poor and totally out of control project. It involves almost every aspect of the agency. The two captains should have been removed months ago. Meanwhile, we all are being sucked down this path of disaster unable to stop the slide. And of course, there is a ton of money involved so just pulling the plug is not possible. But it really was the answer four months ago. Now, we are headed right for the launch at the end of this month.

We were about to roll it out in September when none of really knew what was going on. The night before the first training session, the team of six of us practiced how the training would go and discovered huge issues, so we stopped the roll out. Since then, the team was to resolve these issues so that things would work. But the reality is that they will never work. The system is faulty and does not meet our needs.

I am responsible for training all the staff on this system. There are two factions. One group was launched this week, and I do not foresee any issues with their piece. It is the training that commences with the 250 aides in the middle of the month that is a challenge. Even of the training goes through without a hitch, the after effect, the tsunami, will be awful.

I know that training will be blamed, even though everyone knows we cannot train to the level to thwart this disaster. It is inevitable as the users apply this product. The issue is that the product is not what we should be using. They needed a different system. But the Captain signed the contract and pushed it forward without testing. He continues to fabricate reports to the admin team about how wonderful this product will be. It could not be farther from the truth.

I am not sleeping. I had a cold at Christmas which seemed to get better and then last week it returned. I actually think this was the flu. I had chills Monday night so bad that I crawled into bed and covered myself with blankets and two comforters. But I had to muster on and go to work because there is no one to cover what I do. I have not been this sick in years. And everyone is feeling ill. That is what stress will do to folks.

Because of my PTSD, I have reverted to old reactions that I thought I had worked to subside. I need control in my life. When I do not feel safe, I am reactionary. I fire off in fear and anxiety. I feel trapped in a place I cannot get out and for me, that is the worse. I become a trapped animal. I wake in the middle of the night and perseverate on all the things that are happening and even if I work out a resolution, I will fret and worry for hours until sleep overtakes me again. I wake feeling exhausted and I have the shakes. I cannot meditate because I am so exhausted I fall asleep or I start a cycle of worry. I have tried to use my breathing exercises but have only successfully set off a series of hacking coughs.

In a month, it will be done for me. I will survive. It helps that I know what is physically happening to me. I can control some of the anxiety at times. I am aware when I am flying off and reacting in fear. But the hard thing is to control it before I lose it and it takes over. That is usually in the middle of the night when the demon seems so massive. I am aware again of that endless deep abyss that seems to be right below me and that my grip is weak. It really gives perspective to being on the edge for me.

“I am a sinner. I have done something so egregious in my life that I deserve completely the issue at hand.”

This is how someone who has PTSD brought on by childhood trauma thinks. This is how a woman copes with the reality of living within an abusive relationship of a spouse or family member. This is what the perpetrator tells them and when it is someone you are supposed to trust, you take it as gospel.

The lesson is learned early when in innocence, the child or woman stands up to the inflictions and is beaten worse or punished even more cruelly. There is guilt placed on them that they are so flawed that their judgement is totally wrong. When you add isolation, which often happens, the person is so humiliated because they are led to believe they have caused their own situation and it is their entire fault. So they submit which is why so many people end up either dead or remain in the relationship.

Children often have no escape. They hear nothing but ridicule and criticism. They are abused mentally, physically and sexually by members of their closet trust unit, their family. This circle of constant wearing down of any self-worth is worn like a cloak and the energy given off to others in the world is a reflection of this lack of confidence. People treat people as the person treats themselves. And this only perpetuates their loss of confidence. When all hopes of a bright future are dashed at the malicious behavior of others, the person mentally gives up.

What happens in the body is another story. The body is designed to protect us. I have written a lot about the reaction of trauma and there is a ton of information on the physical deterioration of the human life form from trauma whether it is a one-time happening or many. There is evidence based research on the impact of trauma and the propensity of chronic illness later on in life. Please read the Ace Study information here: http://www.acestudy.org/

Now repeat this treatment for fifty years and then ask, who could possibly have a different outcome of low esteem and self-deprivation? How could the body after all those years of cortisol floods and other hormones and muscles in a permanent clinch all the time not affect the health of someone? This is my story. It is not about sympathy and it is very difficult, more difficult to talk and write about than anything I have ever done because you see….I am a sinner. I still in my subconscious think I deserved everything that ever happened to me. And so the manifestation of chronic illnesses is only another reinforcer.

The reason I am writing about this stems from another blog of the dear Dr. Victo Doloro: https://doctorly.wordpress.com/2015/08/27/eroding/ . It is about how obese patients are treated by the medical community. I wrote a long reply to that but it made me come to grips with something currently in my own life.

A week or so ago, I started to feel like absolute crap. We were headed out for vacation; I was able to quell the uneasiness of my ickiness with the anxiety of the trip. I always am anxious to some extreme, but going away is very difficult. I lose what little safety I think I have. Once away, I still was anxious and I thought it was about work. It is what I do. I find a reason for something so I can deal with the guilt of not being perfect. Although we had a splendid time, I knew something was wrong Big Time. We got back and the symptoms did not get better. If anything, I felt worse. I had my nurse educator take my blood pressure and sure enough it was up there, more so than it has been for a long while. I decided to look at my glucose, and yup, it was up. I took readings for four days and it was constantly up there.

I did a very difficult thing. I called my doctor and made an appointment and I asked him to order all sorts of blood work. On Friday, the lab tests came back and there was nothing significant in the findings. I was within a range I had been in before. This summer had been a whirlwind of barbeques and going out every weekend and enjoying ice cream cones while sitting by the canal. And I just came back from vacation where we treated ourselves to what-ever we wanted including shell fish. I had brought all my numbers down when I was on Weight Watchers and because of the change in eating habits, I actually as mindful on the trip and not a crazy fool. I only gained four pounds back from which meant I was still 20 pounds lighter than where I was less than a year ago. Just knowing that made me feel better.

This morning, the last test came back (urine) and it was off the chart. From what I can tell, my kidney crashed again. I had taken a shot (Simponi for my Psoriatic Arthritis) the Wednesday before we left. I had a reaction at the injection site I have never had before (I have had seven shots of this product) I noticed the next day that I felt like my blood pressure was up and I was very stressed. As I said, the anxiety of the trip and so forth. On the trip, I was not drinking water as much as I normally do because of how much I have to pee every five minutes and you can’t do that when you are traveling. I also consumed restaurant food which has a ton more salt than I use. But according to what I have read, I should have edema, and I don’t. There is also the possibility that the test was contaminated and the outrageous reading is inaccurate.

But here is the point of this long epistle. It took me four days to call the doctor. Why? Because in my mind I am totally blaming myself for whatever is happening. I am in a state of being triggered from guilt and the fear of oncoming punishment. For me, having to go to the hospital for more tests makes everything in my body tighten to the point of almost being crippled. I am sure it is adding to the heighten BP. Worse is the treatment I know I will receive. My GP is not like that. But this will surely mean a trip to a nephrologist and/or endocrinologist. My last experience was beyond awful and I wrote about it in Victo’ s post and I have written before about it. Even the nephrologist I saw never talked to me about kidney disease, but only about he bet me I would be so much healthier if I lost 25 pounds. HELLO??? I did and this happened anyways.

I feel in the depth of my soul like I have been captured like a caged animal and I am trapped. Now I will be paraded like a circus animal where people can poke fun and ridicule me. They will tell me that this is all my fault because I am fat and from the front desk to the person who will have to weight me, they will treat me terrible. It is an awful feeling. But I know I have to do something. My fear at one point was so strong that I almost said “screw it. I have to die of something.” Then my new found bravery came into play and I am facing this head on. First asshole who says something that this is my fault because I am fat is going to get an earful from me. I wish I could come up with a card to hand out starting with, “ you are an uniformed asshole! IF you only knew…..” The other thing that this and the conversations on Victo’s blog did was reinforced my desire to continue to work in trauma informed studies. I completed a certification last year in working with organizations to be more trauma informed. There is another longer certification in becoming a trauma informed specialist and I am going to go for that this year.

I know that the fear of seeking medical help is extremely common. The level of anxiety brought on from illness for people with PTSD from any form of trauma is unmeasurable. It is a major cause of suicide. It is only in recent years that PTSD is acceptable for people in the military. It was not uncommon and is still prevalent for soldiers returning to suffer major uncorrectable illnesses because of PTSD. They try to treat the illness and not the whole situation. There is still a stigma of being a weakling. People with childhood trauma and domestic violence victims are very much not understood or even accepted. Countless doctors do not do a trauma screen to see the route of diseases started back when they were physically abused when they were five. And until we stop degrading and humiliating the victims, they are not going to speak up.

I am going to add to this, although I know this is going to be another post at another time. There is a lot of work out there dealing with people with PTSD and downregulating the body reaction to it. There is ton of stuff on mindfulness and meditation and sensory and energy work and other therapies. I have spent a ton of money and years on trying to find a solution. Although it has helped, some more than others, I am convinced that this is not the cure. I believe there is some so deeply engrained in the body that no one has actually discovered and is able to truly turn off. They can dim it, but not eradicate it. And, like anything, it is hard to say that this too is a failure. But this is all for another time.

This first shot is the garden just after we had the beds mulched and the snow was official gone. However, Mr. Frost stopped by two more times.

My garden is my sanctuary. It is also a blank canvas where I paint with flowers. I love to spend my weekends working on it. I usually overdo it and hurt for several days later. But the joy I get from coming home and sitting and looking at all the different plants, flowers and “garden junk” I have planted is worth every ache. We ended up as we do every winter with no grass. The combination of many trees which deposit many leaves, running feet of dogs and too much snow kills off whatever is left at the end of summer. Vegetation was very sparse this winter and many trees and shrubs were eaten by animals to survive the winter. Even though our garden is walled on all sides by a fence, we have two resident rabbits. I ended up feeding them carrots on our deck and bird seed. They have remained members of the garden club and that’s ok with me.

This year’s addition was a new rock wall garden. I wanted to finish the end of deck off. We also tilled the lawn by hand and reseeded it. I usually plant three flats of impatiens in pots. This year, the growers have put a ban on them because they get a blight. Mine did not last year but they did the year before. My favorite grower grew their own so I found a variety of them. I pot them up and it usually takes me a few weekends to get it done. This is just the first planting.

I also have many perennials and statues. I hang pots everywhere. The lawn is coming in great. I also collect solar lights and the garden at night is magickal.

Thanks for visiting and stop bye later when I will have many more photos.

I have been working on a professional certification in Trauma Informed Organizations from the University of Buffalo. I want to champion this cause for people like me. You know; the overly sensitive ones. Someone who seems to be fine and then all of a sudden, they seem out of it, depressed and short tempered. And you cannot figure out why they are “over-reacting.” This person goes into a tail spin over a simple comment. These are people who seem to be worriers and drama queens. They can be a co-worker or someone who is a customer. It can be terribly difficult to work with them, or try to provide a service for them. If you are a fixer type personality, this kind of flighty reactionary personality is very trying.

The first thing I got involved with is the ACE study. Here is a link to information about the ACE study and the findings: http://www.cdc.gov/violenceprevention/acestudy/about.html This information was so connecting for me. I took the test and have an incredibly high score of 8. I came from a white affluent family with no apparent (to the world) issues. But the truth is my parents were alcoholics, abusive alcoholics. And my sister has mental illness and she too was abusive. I have come to terms with the history, but it affects me often in how I deal with things as an adult.

On top of this, I am an empath. That is someone who is very sensitive to how others feel. In the Woo Woo World, we are considered seers and fortune tellers. We are able to “read” people. The truth is it is a skill set necessary to survive in a family or any dangerous environment. You need to be able to “read” people to see if there is a dangerous threat coming from them. I read eyes very well as they really are the portal to the soul. For some of us, it is not desirable as you cannot turn it off. I can sense people’s real feelings sometimes before they can. People love to come to me to tell their tale only because I am often able to dig in and see things they may not.

But I am also affected very much but the climate of the people around me. For example, right now at work the climate is one of fear. When people are fearful, they turn nasty and Nasty is what it has been every day for the last month. The Mothership has ordered an “Engagement” with a consulting group, Fazzi, to come in and look at the organization. We were told heads would roll. So far, two people have been let go. The Admin team is sweating bullets and so they are sending terrible fear throughout the organization. One VP announced her early retirement already. It was a wise choice.

Two years ago, we bought another agency and we were supposed to be one organization by now. All of their executive team left and what is left are a few directors who are in a tenuous situation. The bigger issue is that they have not played well in the sandbox. One of the things this engagement is to discover is where services can be combined and supervision eliminated. Finally. This was the plan all along, but our touchy feely board did not follow through with the combining. Two years ago, the then CEO told me that I would be in charge of education. The person at this other organization was not scheduled to be let go because she only works part time. But she is to report to me. She is a NP. I am not. She does not want to report to me. Bottom line and she has made it very apparent. It has caused some major compliance issues because she does not embrace our way of documenting. There is a lot more to this. There are little battles of strategic survival all over both agencies. This is just one situation in a sea of pissing contests going on right now.

The result for me right now is I come home from work totally exhausted. I have been keeping to myself as much as I can. There are a lot of projects that I am responsible for that require cooperation from many people and it ain’t happening. Part of the issue is the uncertainty; the other part is the underlying flow of fear. I sense it and it has triggered me to be in a hyper arousal, hyper sensitive mode. By the end of the day, I am so worn out from just trying to keep it together. My mind knows there is nothing I can do about it. I do not have the ability to control anyone else, only my reaction. But clearly, I am not controlling myself either. I slipped up at lunch recently with my fellow HR managers. We go out to lunch periodically, and to have not gone would have been worse. So we were talking about how tired and cranky we were and I said, “I know, I went home and sat out in the garden last night and just cried.” Later, one manager came over and was totally freaked that I would be crying over my job. I do not have the desire to tell her all about trauma and my history. Crying for me is a release. The breathing and shaking all release pent up chemicals and relax my muscles. She is trying to be a friend, but I know she wants to fix me.

This type of stress is very prevalent in companies that are looking to “squeeze the buffalo on the nickel to save a dime.” (That’s a father-in-law comment) The admin team and CEO could have presenting this engagement in a better light. They should have waited on the terminations for a few more weeks. Since these two were not administrators or even supervisors, the fear now has extended to all ranks. They announced they are changing the pay structure for only the field nurses. No more pay per visit, which has been a money maker for some. Yet, they have not implemented it so the fear of loss of personal revenue is floating around. They are putting together two new teams and are pulling existing staff from the field to do this without filling their positions in time. It is so simple: hire the amount of people now you need to take out later, train them, get them up and successful, and then form the new teams. But no, that would make sense. And let’s do this during the summer when we are short anyway from vacations. The list of incredible poor planning is extensive. If they could see how their lack of governance has affected the organizations and instead used mindful awareness of being trauma informed, it might change how this would all be going down. Trauma informed does not mean to pussy foot either. It means to eliminate unnecessary fear and ambiguity. It doesn’t change what will happen, only how it is communicated and presented. Have a clear plan, have boundaries and guidelines, and people will know what to expect. It is much easier to deal with than fear.

I had so many titles for this post. “Which end is up?” “Danger, blast site!” “It’s all water in the end.” All’s well that ends well.” “Up periscope!” Can anyone guess what I am prepping for? I have been perseverating about this for about a month.

I have been having some digestive issues…well actually my whole life. It started when I was a kid. My mom’s remedy was horrible and she used it frequently. I think this is one of the reasons I am having such a hard time. It was quite common in the fifties before they had prepared medicine you could get at the store. (If they had them, my mother never used them) Instead it was a humiliating process with hot soapy water. Ghad! Even now I cringe.

I cannot believe I have shared this memory as it had lurked in my head hidden for years. But there it is. I am usually not bothered by tests such as scans, scopes and so forth as I have had several. I was diagnosed about seven years ago with diverticulitis. It is highly probably that it is part of the disease process from my psoriatic arthritis.

About three years ago, I started having real issues. Scary, “I hope I can make it and no one is in the bathroom” moments, that are the nightmare of anyone who has an issue like this. People with IBS and Crohn’s know of what I speak.

When I was a younger woman, it was the fear of a monthly accident. And I had some horrible moments that including leaving my uterus in a chair in a conference once. I escaped with blood pouring down my legs. “Gee, I hope no one saw.” Yeah right. I was so prolific that I used carry a drug store of protection with me everywhere along with a change of clothes. Instead of the riding the cotton pony, I would eye ball sheep!

When I had my period medically stopped, it was like a new lease on life. My last period lasted for three months. I was heading for a transfusion when they decided to stop it at first with a shot and then with a procedure. Lucky for me, I went into menopause and never had an issue again with that.

And now, I still am tied to being near a bathroom for a completely different reason. I joked with my friend that we are only changing the need of protection but we came in wearing diapers, went to pads for different reasons and back to diapers, I am sure.

So I am hopeful that the colonoscopy will not discover anything that can’t be easily fixed. I am also hoping to get some help with the digestive issues that are part of the problem. I am talking about that food comes and goes almost in the same form. I normally eat a high fiber diet: salad, veggies and fruits. Now, I can eat like that for only so long before I have an issue. Then, the opposite occurs for a while and on it goes in a cycle of on again and then off. Either way, I am in pain much of the time. I am almost used to it.

Like an idiot, I have done research…. It’s what I do. Unfortunately, I have discovered and now it is haunting me that I have every symptom of colon cancer except bleeding, which is fascinating because I am on a blood thinner. The one that is weird is feeling cold. I never have felt as cold as I have in the past months. It is an internal chill that does not dissipate with warmer clothes or even tea. The other symptom is losing weight. I have lost about 23 pounds. But I am trying to lose weight. But in all honesty, I am not trying all that hard. And it is coming off.

So I am off from work tomorrow to drink the Kool-Aid, so to speak. I am scheduled early Friday morning for the actual procedure. I took off not only because of the shared bathroom issue, but because I have been a blithering idiot the last two days. Some people know why, but not everyone. I am frightened also that the prep may cause damage. I am actually scared I will have a blowout. And although I am sounding like I am joking, I am not. I won’t sleep much tonight. I just hope everything comes out alright….. literally.

I am currently working on a certification from the University of Buffalo on Trauma Informed Organizations. I have been studying trauma related materials for a while. It has been fascinating and helpful healing for me.

What is a Trauma Informed organization? It is an organization that has taught trauma informed care from the person who answers the phone to the CEO. It is the basis for policy and procedures. Trauma informed agencies and organizations are totally aware that every contact with a patient makes a difference in their reaction to the care being offered and also in their ability to get well.

For example, a person with mild PTSD is coming to see a doctor for stomach upset. The admission person snarls at them because they are lacking some information on their admission form. She tosses the clip board at the patient and says snottily, “you need to fill out all of the information!” She is line with several people behind her. (Having people behind you is a big trigger for trauma patients.) The client/patient did not fill out all the information on purpose because she is not ready to share her details yet. She will once she sees the clinician but not with everyone else. It is her right. Her stomach issues are actually a response to the stress from domestic violence, but she is not going to share that easily. A trauma informed organization treats everyone like they have a trauma. The clinician who she eventually works with should request a trauma screen once the patient is comfortable with the plan of care. By doing a root cause analysis, then, and only then, will the real healing begin.

Trust is huge along with safety for someone who is traumatized. Just walking into a new environment is bad enough, let alone in a waiting room with strangers, standing in line and having to answering questions to someone who does not give a rats-ass about why your there.

Another perfect example of a non-informed practice is the process of getting vitals. This is me: I am sitting way too long in the waiting room. Other patients are called before me. I start to worry why I am not getting called back. Did they forget me? (Blood pressure begins to rise) Finally someone swings the door open, and even though I have been coming to this practice for years, and they all know me, they bark my name from across the room. I get my stuff and in a cadence for jogging, we go back to where all the rooms are. They stop and bark “get on the scale.” I am immediately humiliated. Blood pressure is really rising. Then we trundle off to the little room where she asks questions about meds. She pulls a cuff from the drawer and puts it on over my sweater. The pressure is high. She sharply asks me why I am there. Of course by this point I am upset.

This is how I dealt with this. I sit near the door so they do not have to yell across the room. I refuse the scale….which used to be a fight. But it is your right and the trauma issues getting weighed causes me…well, they know now not to ask. I tell the doctor because I weigh myself every day. In winter, the clothes you have on can add many pounds. I make them use the right sized cuff and on my skin. It bothers me that they don’t wipe it down afterwards. Surprisingly since I started doing this my blood pressure readings have been wonderful. When they ask why I am there to see the doctor, I simply and nicely say, “I will tell the doctor” or I say “follow-up.” They have no reason to know. If I need a shot, the doctor has to order it and he will tell them.

Being a trauma informed organization can only improve healthcare across the board. Non-adherence and non-compliance are huge issues. Patients need to want to take their medicine and follow their plan of care to improve their health. Our medical system in the USA is totally reactive. We spend millions on after-the-crisis care. Being trauma informed and using methods such as trauma screenings and motivational interviewing can only improve patient care.

Being trauma informed is for all health organizations. The scenario I described about myself is my GP at a family practice. Even though I work in homecare, being trauma informed can be practiced there as well. It can be used in every environment where there is a community. When we see people who seem out of it, or stand-offish or short tempered, it would be mindful to remember: You do not know the whole story.